Simulation training has taken hold as a key method for safely teaching procedural proficiency. Prior studies have found simulation to be superior to traditional didactics in improving skills and behaviors. This systematic review focused specifically on whether the skill set obtained from simulation is transferable to the operating room. The study was restricted to randomized controlled trials involving novice surgical trainees. The findings demonstrate a positive impact on operating competence, but the metrics used in studies thus far have been limited. The authors advocate for more robust assessment of operative performance. A recent systematic review, published as part of the AHRQ Making Health Care Safer II report, also found evidence that simulation training improved procedural competence and patient care outcomes. An AHRQ WebM&M perspective by Dr. David Cook reviews the literature on health care simulation training.